Chances are, your healthcare costs have been headed in one direction over the last few years. That would be up. Whether we’re talking about insurance premiums (up 41 percent since 2003 according to research by The Commonwealth Fund), deductibles (up 77 percent), prescriptions or copays, the answer to how much of a share of your monthly nut is eaten up by healthcare is more, often much more.
So what can you do about it?
How about negotiating? Actually asking for a better deal from your doctor, your local hospital, from any provider of medical services. I know, you were likely raised to believe this is heresy. Doctors are to be respected. Questioning them about the treatment they recommend is hard enough (that’s why so many second-opinion getters continue to do so quietly) but questioning them about whether they could see you for less? It sounds like a complete and total no-no. It’s not.
The first time I prepared to do a segment on this topic on "The Today Show" with Dr. Nancy Snyderman, I remember divvying up the labor. She, of course, would talk about the medicine. I, of course, would talk about the money. Except, I stressed, when it came to whether or not you can negotiate with your doctor. That, I said, people need to hear from you. So that morning she said – as I’ve heard her say again since – yes, you can negotiate with your doctor.
The question is how. Here are several tactics you can try:
- Talk about the cost upfront. Would you buy a car without asking the price? I don’t think so. There are no posted prices for medical care, so ask what the bill will likely be. Will there be labs? How much will they cost? Can you be sure they are done at facilities your insurer will pay for? And is there any way to bring that bill down. If you can’t afford something, it’s better to say that in advance and ask your doctor for less expensive alternatives. Many doctors will work with you. And if you aren’t able to muster the nerve to talk directly to your doc, then talk to the billing manager instead.
- If you’re paying cash, or in advance, say so. Over the past decade, many doctors have had to staff up to deal with the nasty and often tricky business of getting reimbursed by insurers. If you are willing to pay cash – and not go through insurance – do yourself a favor and let the doctor know. Then ask if the bill can be adjusted as a result.
- Ask for a payment plan. If you aren’t able to negotiate a better price, you may be able to negotiate better terms – the ability to get the service now but pay for it over time.
- Do some homework. Hospitals charge different prices for the same rooms and procedures – depending on who’s paying the bill. The lowest cost often goes to the biggest insurer in the land, i.e. Medicare. Digging around online, you can find what Medicare reimbursement rates for specific procedures are. Then use that to start your negotiation with the business office of a hospital. If you don’t have insurance and are paying out of pocket, this can work to your advantage.
Jean Chatzky, award-winning journalist and best-selling author, is the financial editor for NBC's "Today," a contributing editor for More magazine, and a columnist for The New York Daily News. She is the author of six books, including her newest, Money 911: Your Most Pressing Money Questions Answered, Your Money Emergencies Solved. Check out Jean's blog at JeanChatzky.com. You can also follow her on Twitter and Facebook.
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